Ethical values

Ethical values are universal rules of conduct that provide a practical basis for identifying what kinds of actions, intentions, and motives are valued (Haddad & Geiger, 2020). Sometimes ethical values misalign with evidence-based practice because of ethical values based on personal and social goals not supported by scientific knowledge. The discussion will be about why the ethical measures created for clinical investigation could be feasible for EBP implementation projects as well as explore three major controversies that are associated to the taking action of evidence-based quality improvement (EBQI) initiatives. The paper will also talk about the ethical principles that dispute with the knowledge of ethical rights of the patient in healthcare improvement

Part 1

Ethical Safeguards

Ethical protection is established to guide how clinical survey is carried out while observing patients or public ethics and putting in place the evidence-based practices. These safeguards limit the collection, patient treatment, and making of decisions. The ethical safeguards comprise of alternative decision making, consent that is informed, data safety monitoring boards, institutional review boards, as well as confidentiality measures. These ethical safeguards designed to protect research volunteers in ensuring their rights and well-being. These safeguards influence the patients’ participation decisions that must be free from influence by the researchers conducting the study (Roberts et al. 2015).

The researchers must collaborate their clinical research with the ethical safeguards to eliminate the chances of neglecting the guidelines set to protect the research on the vulnerable population such as psychiatric patients. The informed consent safeguard directs the researchers in ensuring that the participants are fully aware of all the goals of the study, the requirements, possible outcomes, and consequences that might not be positive or might impact the health status of the participant (Roberts et al. 2015). Evidence for practices is made available for the healthcare practice and decision making through following the appropriate channels despite how difficult that might be as these concepts depend on evidence collected for the advancement of the practice, quality care, and patient outcome.

EBP seeks information from patient’s history, which requires consent for release as the limits of the ethical safeguard what information accessed, by whom, when, and how long (Bhargava & Bhargava, 2007).

The nurse’s commitment focuses on the patient as an individual, or a family, community, or group, and population. Nurses must consider the patient or individual’s thoughts into care practices to limit the conflicts of interest with the patient or external organization. Collaborations between the external and internal teams included to foster best patient care as the professional boundaries relating to the patient care outcome is essential. Nurses could view this as a limitation in the implementation of evidence-based projects as it impacts the ethical safeguards in practice (Haddad & Geiger, 2020).

Part 2

Ethical Controversies

Every activity carried in healthcare that involves a patient needs to assessed to ensure patient’s rights observed. Differentiating between evidence-based implementation and clinical research initiatives, is vital in the collection of informed consent and avoidance of other controversies that comes along with study and research processes. Clinical research is the activities that directly involve people or material from people. According to Melnyk and Fineout-Overholt (2015) when it comes to evidence-based practice quality improvement initiatives they tend to be systematic in nature in terms of activities that are meant to immediately improve the health care delivery in a specific certain setting. Any of these activities can call for a need for clinical appraisal to ensure patient rights observation.

Several controversies are noted from the “Two ethical exemplars” in the textbook. The controversy one is the attempt to provide improved quality care when it comes to patients that may cause harm to the patient.

Despite following the values of beneficence, there is a chance that non-maleficence and justice values jeopardized.

Some patients can suffer from the activity while others benefit. For example, the use of chlorhexidine baths before insertion of catheters and devices in nursing units yields excellent results in decreasing catheter-associated infections. However, some issues are arising from it. Some patients might show sensitivity to the chemical composition of the solution, which could result in damage to the skin or significant other reaction symptoms. Although the goal is to reduce the chances of infection, some patients will need more treatment related to the outcome, which leads to no-maleficence.

The second controversy is noted with the indecisiveness to collect informed consent before performing the activities, especially when the investigators believe the study is EBPQI instead of clinical research. The patient’s right to autonomy violation in this area. Patient consent obtained no matter what the study the activity falls under to ensure that both the patient and investigator’s rights are protected those of the patient particularly. The patients should have information about every activity that involves them to avoid the assumption of the general consent of treatment to cover the EBPQI.

The third controversy is related to the use of resources and its distribution in researching and implementation of evidence-based activities that could result in the waste of resources, time, and workforce. The distribution of the resources in one area f study activities can be unfair to the other areas that need some of the resources. Accurate appraisals conduction to ensure every corner of these activities is justified, and the potential outcome will not consume too many resources needed for the general care of all patients.

Part 3

Conflicting Ethical Principles

Several ethical principles can result in conflicts with patients’ moral rights to improve healthcare. The patient selection should be fair, which involves the use of inclusion as well as exclusion criteria when it comes to recruiting researches that are based on scientific rationale, not the issue of vulnerability or/and convenience (Melnyk & Fineout-Overholt, 2015). The human subjects must be voluntary to maximize participation as a lack of knowledge of areas to improve in healthcare might impact the outcome. Educating the patients on what to do or what the expectation accomplishment to meet the goals of improvement could be beneficial for all involved.

The second principle is the importance of informed consent for the participating in the research and the treatment (Melnyk & Fineout-Overholt, 2015). Obtaining informed consent for any activity that involves patients or human material gives the patient or participant the power of autonomy, thus does the research or study legitimate and valuable. It also makes the patient feel a sense of respect, which is another principle of ethics. Respecting the human subjects enables them to have a sense of value in the research not used then disposed of off when done like a paper towel—the well-being of these individuals in the research prioritization over the studies.

The fourth principle is that the research must have favorable risks to benefit ratio with all the research, EBP, and EBPQI (Melnyk & Fineout-Overholt, 2015). There must be a commitment to minimize the risks and maximize the benefits of all studies and projects to ensure that patients or participating subjects exposure to projects that could cause significant damages with fewer gains. This limits the wastage of resources and time used during the activity. The drastic damages can result in human subjects not willing to participate in the next project that can lead to improvement in healthcare.

Conclusion

Healthcare researchers should always observe the guidelines and safeguards that could be conflicting with the research methods used in human subject as these guidelines are provided to protect the subjects. Collection of informed consents prior to any activity remains the priority in any step that involves human subjects no matter how small it is. Critical analysis needs to conducted to ensure clinical research and EBPQI confusion, which can result in the omission of the collection of informed consent. Ethical principles designed to protect the patient, investigators, and the validity of the research or study, but the patients still retain the priority in any activity to be performed.